CBES - PowerPoint Presentation

Slide1

CBES Essentials for Residents, Fellows, and Faculty

A 10-minute primer

on student performance assessment in required clerkships

Stanford School of Medicine

July 2014Slide2

ContentsCriterion-based vs. norm-based evaluation

Criteria for PWD

Exceptional Patient Care

Exceptional Professionalism

and Interpersonal Communication

Final Exam

Clerkship Evaluation Teams

Role of resident, fellow, and faculty evaluators

Fairness, Accuracy, & Timeliness

Brief interactions

More informationSlide3

Criterion- vs. Norm-based evaluationStanford’s performance evaluation system in required clerkships is criterion-based.

All

students whose performance meets established criteria can earn a top grade of Pass with Distinction - regardless of how other students perform.

This is in contrast to a curved or norm-based system, where only a certain proportion of students can earn the top descriptor of performance.Slide4

Pass with DistinctionStudents may earn a Pass with Distinction in each of three domains:Patient Care

Professionalism and Interpersonal Communication

Final Exam

Grades for each domain are reported separately in the MSPESlide5

Patient Care The School of Medicine has adopted the RIME framework (Pangaro,1999) to describe performance in Patient Care.

The RIME framework is based on the understanding that students move through a sequence of developmental stages:

Reporter

Interpreter

Manager

Educator

Click here for a more detailed description of RIME stages.Slide6

Patient Care Students must function in the Interpreter stage to pass each core clerkship.

Pass with Distinction requires functioning in the Manager stage.

Managers must consistently demonstrate

strong

Reporting and Interpreting skills.Slide7

Expected Transitions

MANAGER

POM

Core clerkship

Sub-Internship

Residency +

INTERPRETER

REPORTER

Core clerkship students are expected to be in the Interpreter stage. Functioning as a Manager – during a

required

clerkship –

earns a

Pass with

Distinction

for Patient Care.Slide8

Direct observation As part of the required clerkship evaluation system, students are required to arrange direct observation of clinical skills by a resident, fellow, or faculty member.

Each clerkship has developed a form to guide direct observation.

Observers are not required to watch an entire H&P. Brief observation of part of an interview and/or exam will do.Slide9

Professionalism/IPC To earn a Pass with Distinction for Professionalism and Interpersonal Communication, students must demonstrate:

An absence of behavior that raises significant or consistent concerns

Consistent evidence of exceptional Professionalism and Interpersonal Communication with both patients and the medical team (See examples on the next slide.)

In addition, students must request multisource feedback from patients, peers, and non-MD staffSlide10

Examples of Exceptional Professionalism and Interpersonal Communication

Student:

Extends him/herself beyond usual duties to ensure patients' comfort or well-being

Advocates respectfully and diplomatically on behalf of patients

Serves as patients' preferred source of information and/or

support

Makes an extra effort to support or help fellow students and others excel

Without prompting, takes on extra work to help the team/preceptor

Supports the team by paying attention to the needs and care plans of patients other than those assigned

Maintains composure and manages conflict in difficult

situations

Makes an extra effort to participate in learning opportunities beyond those required

Seeks and responds openly and proactively to feedback

Demonstrates an advanced degree of personal responsibility and accountability– beyond being punctual and reliable.Slide11

Final Exam In clerkships using the NBME Subject Exam, an exam score between the 75

th

-80

th

percentile

earns a Pass

with Distinction

for the final exam.

Clerkships using non-NBME exams have set comparable thresholds for Pass with Distinction.

Clinical application of knowledge and efforts to expand knowledge are assessed as part of Patient Care and ProfessionalismSlide12

Clerkship Evaluation Teams Each clerkship has established an Evaluation Team to review student performance data and assign final grades.

Evaluation Teams are required to submit final grades and evaluations within 4-6 weeks of the end of each rotation.Slide13

Role of Residents, Fellows and FacultyIndividual residents, fellows, and faculty will not be asked to assign final grades or judge whether students should earn Pass with Distinction.

The role of each individual evaluator is to:

Respond promptly to requests for input on student performance

Describe

observations of student performance

Provide real-time feedback to students based on

observations of performanceSlide14

Requests for Input Individual clerkships may use any or all of the following mechanisms to gather input on student performance:

Electronic forms (E*Value)

Paper forms

Email

Team meetingsSlide15

Evaluation FormTo link to

the Patient Care - Professionalism form used to collect resident and faculty input on student performance

,

see the CBEI

Essential Information, Tools and Forms pageSlide16

Fairness, Accuracy & TimelinessTo ensure that student performance evaluations are as fair and accurate as possible, clerkships must collect information from the full range of residents, fellows, and faculty who work with each student.

Please respond promptly to clerkship directors’ and coordinators’ requests for information about student performance.Slide17

Brief interactionsQ:

What if I didn’t have enough contact to decide whether a student functioned as a Manager or demonstrated exceptional professionalism?Slide18

A note on brief interactionsA:

The

role of each resident, fellow, or faculty evaluator is to describe observations of student performance. Clerkship Evaluation Teams will review and synthesize

information to assign final grades.

Multiple

brief observations from multiple evaluators will fall together as themes and trends. ALL input is valuable.Slide19

More informationFor more information, see the

CBES website

or contact one of the following people:

Elizabeth Stuart, MD,

MSEd

- Assistant Dean for Clerkship Education,

aestuart@stanford.edu

Sara Clemons, MEd - Assistant Director for Clerkship Education,

sclemons@stanford.edu

Thank you for your commitment to medical student education.